PT  - JOURNAL ARTICLE
AU  - Christoph Becker
AU  - Alessandra Manzelli
AU  - Alexander Marti
AU  - Hasret Cam
AU  - Katharina Beck
AU  - Alessia Vincent
AU  - Annalena Keller
AU  - Stefano Bassetti
AU  - Daniel Rikli
AU  - Rainer Schaefert
AU  - Kai Tisljar
AU  - Raoul Sutter
AU  - Sabina Hunziker
TI  - Association of medical futility with do-not-resuscitate (DNR) code status in hospitalised patients
AID  - 10.1136/medethics-2020-106977
DP  - 2021 Dec 01
TA  - Journal of Medical Ethics
PG  - e70--e70
VI  - 47
IP  - 12
4099  - http://jme.bmj.com/content/47/12/e70.short
4100  - http://jme.bmj.com/content/47/12/e70.full
SO  - J Med Ethics2021 Dec 01; 47
AB  - Guidelines recommend a ‘do-not-resuscitate’ (DNR) code status for inpatients in which cardiopulmonary resuscitation (CPR) attempts are considered futile because of low probability of survival with good neurological outcome. We retrospectively assessed the prevalence of DNR code status and its association with presumed CPR futility defined by the Good Outcome Following Attempted Resuscitation score and the Clinical Frailty Scale in patients hospitalised in the Divisions of Internal Medicine and Traumatology/Orthopedics at the University Hospital of Basel between September 2018 and June 2019. The definition of presumed CPR futility was met in 467 (16.2%) of 2889 patients. 866 (30.0%) patients had a DNR code status. In a regression model adjusted for age, gender, main diagnosis, nationality, language and religion, presumed CPR futility was associated with a higher likelihood of a DNR code status (37.3% vs 7.1%, adjusted OR 2.99, 95% CI 2.31 to 3.88, p<0.001). In the subgroup of patients with presumed futile CPR, 144 of 467 (30.8%) had a full code status, which was independently associated with younger age, male gender, non-Christian religion and non-Swiss citizenship. We found a significant proportion of hospitalised patients to have a full code status despite the fact that CPR had to be considered futile according to an established definition. Whether these decisions were based on patient preferences or whether there was a lack of patient involvement in decision-making needs further investigation.Data are available upon request.